I am trying to appeal thousands of dollars in medical bills from when my boys were in the NICU.
You see, I thought that I did my homework - I found an obstetrician, pediatrician, perinatologist and a hospital to deliver at that were all in my network. The nurses for me, the nurses for the babies, the anesthesiologist, the radiologist, the cardiologist, the pulmonologist basically almost everyone that saw me or the twins before, during and after the hospital were all in-network providers. Except for one group of doctors - the Neonatologists, the doctors who were 'in charge' of my boys in the NICU. And unbelievably, their bills total more than $200,000 for the 14 days the twins stayed in the NICU. WOW.
Well, I am arguing (rightly so I might add) that I had NO idea that my hospital contracted out their Neonatologists from a medical group that apparently doesn't carry my insurance. And at the time of delivery, I had NO say as to whether or not I wanted my babies seen by the NICU drs. I had been in that same hospital TWICE before my delivery (once for an entire week) and not one person in the admitting or billing department brought up a thing about the NICU drs not working with my insurance. And I had talked to my insurance company before my delivery and that had given me the OK on this hospital and drs etc.
I have argued with multiple medical providers and a ridiculous number of UMR employees on the phone DOZENS of times, many ending with me in tears. I am not asking them to drop all my bills completely, I simply want them adjusted to reflect the in-network pricing that I feel I should be charged, which will still be thousands of dollars. But right now the bills I'm getting are literally 3 times the amount we calculated before the delivery that we would have to pay. THREE TIMES!!!
So, I just sent an official letter of appeal to the Claims Appeal Unit for UMR in SLC. Wish me luck. We sure need it. I sure hope it doesn't get lost in the mail...
7 comments:
What a nightmare! So sorry :( Looks like you have a good case, hope your letter gets in the right hands and it's all taken care of soon. I hate dealing with medical insurance... why do they have to make it so confusing?
Your twins are absolutely adorable and you are being an amazing mom!
I have had to fight insurance our insurance company who said they would pay for Michael's special formula when he was an infant (cost us $45 every 2.5 days). They said they would pay for it, but in the end they never did. I lost my battle with them, but I wish you better luck. Here are some suggestions I have. Get a record of all the phone conversations you had with them regarding in-network approval (they keep track of all of their notes, etc). Your husbands employer should have a health advocate that you can use (they will go to bat against the insurance company), and also contact the state of Florida insurance commissioner or agency and file an appeal with them. Good luck!!!
wow, not fun to deal with. I hope it gets worked out. Yeah, I would assume whatever doctors are on call at the hospital would for sure be covered by your insurance....like if I went to OSU all the docs there would take OSU insurance...but if I went to Riverside they don't take OSU and they would tell me that I would not be covered. ugh. Well, at least there is no interest right? You can say you want to make min. payments every month and they won't charge interest....that is what OSU did when we had our last 2.
ugh i am SOOOO sorry. i hate medical bills.
WTH this is joke! I hope you get it appealed.
Thats awful. Im sorry you have to go through the process of appealing all the bills too. What a lengthy ordeal.
This is kind of late, but I am officially wishing you luck. I am so amazed that you can actually update this blog at all! Wow. You inspire me. :)
Post a Comment